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Social Work Publications Department of Social Work

1997

The prevalence of child sexual abuse: integrative

review adjustment for potential response and
measurement biases
Kevin M. Gorey
University of Windsor

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Gorey, Kevin M.. (1997). The prevalence of child sexual abuse: integrative review adjustment for potential response and measurement
biases. Child Abuse & Neglect, 21 (4), 391-398.
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 Child Abuse & Neglect, Vol. 21, No. 4, pp. 391-398, 1997
Copyright 0 1997 Elsevier Science Ltd
Pergamon Printed in the USA. All rights reserved
0145-2134/97 $17.00 + .OO

PI1 SO1452134( 96) 00180-9

THE PREVALENCE OF CHILD SEXUAL ABUSE:

INTEGRATIVE REVIEW ADJUSTMENT FOR
POTENTIAL RESPONSE AND MEASUREMENT BIASES

KEVIN M. GOREY AND DONALD R. LESLIE

School of Social Work, University of Windsor, Windsor, Ontario, Canada

Abstract-This integrative review synthesizes the findings of 16 cross-sectional surveys (25 hypotheses) on the
prevalence of child abuse among nonclinical, North American samples. It is essentially a research literature on sexual
abuse; only one of the studies assessed physical abuse, and there has not yet been a single study of prevalent child
emotional abuse nor neglect. The following summative inferences were made: (1) response rates diminished signifi-
cantly over time, M = 68% prior to 1985 and h4 = 49% for more recent surveys, p < .05; (2) unadjusted estimates
of the prevalent experience among women and men of childhood sexual abuse was 22.3% and 8.5%, respectively;
(3) study response rates and child abuse operational definitions together accounted for half of the observed variability
in their abuse prevalence estimates, R* = .500, p < .05; (4) female and male child sexual abuse prevalence estimates
adjusted for response rates (60% or more) were respectively, 16.8% and 7.9%, and adjusted for operational definitions
(excluding the broadest, noncontact category) they were 14.5% and 7.2%; (5) after adjustment for response rates
and definitions, the prevalence of child sexual abuse was not found to vary significantly over the three decades
reviewed. Given the large human costs, both personal and social, of child abuse, and the identified gap in the
requisite knowledge needed to steer effective preventive and treatment interventions, it is time to invest in a large,
methodologically rigorous, population-based study of child abuse which, if it does nothing else, spares no expense in
ensuring very high participation. 0 1997 Elsevier Science Ltd

Key Words--Child abuse, Prevalence, Bias, Response rates, Abuse definitions.

INTRODUCTION

CHILDREN’S EXPERIENCE OF abuse and neglect has many deleterious consequences over
both the short- and long-term; examples include: behavioral problems, poor self-esteem, feel-
ings of isolation, depression, self-injurious behaviors including substance abuse, suicidal ideas
and behaviors, revictimization, academic and vocational problems, sexual disfunctions, crimi-
nal behaviors, and so on (Beitchman et al., 1991; Beitchman et al., 1992; Crouch & Milner,
1993; Malinosky-Rummell & Hansen, 1993). Three decades of research on child abuse has
clearly underscored its public health importance, however, the most basic questions in this
field, that is, those which are concerned with the problem’s magnitude (prevalence and inci-
dence) have not yet been unequivocally answered; prevalence estimates vary widely (ranging
from 3% to 62%) across methodologically dissimilar samples of different people and times.
Previous reviews, specifically, of child sexual abuse, have also disagreed on incident change;
one estimated that there has been no change over the past 40 years, while another estimated
a two-fold increase during the same period of time (Feldman et al., 1991; Leventhal, 1988).
Alternatively, a Canadian survey concluded that the problem has diminished by one-third over
the past 10 years (Bagley, 1990). Adding still more confusion to the issue are agency-based

Received for publication June 11, 1996; final revision received September 19, 1996; accepted September 24, 1996.
Reprint requests should be addressed to Kevin M. Gorey, Ph.D., M.S.W., School of Social Work, University of
Windsor, 401 Sunset Avenue, Windsor, Ontario, N9B 3P4, Canada.
391
392 K. M. Gorey and D. R. Leslie

studies of clinical samples which tend to infer the increasing prevalence of abuse; caseloads
have increased two- to four-fold over the past two decades (Lindsey, 1994, U.S. Department
of Health and Human Services, 1988). Their findings may, in fact, be more parsimoniously
explained by increased public and professional awareness of the problem, and their increasingly
effective response to it through earlier identification, assessment, referral, and intervention.
The lack of empirically rigorous prevalence and incident change child abuse estimates
represents more than an interesting research issue. Without a demonstrable problem baseline,
it is not possible to examine the impact of changes in the treatment environment, societal
attitudes, nor individual and family demographics. Furthermore, while in the short-term, high
abuse estimates may lead to augmented resources for treatment and prevention, in the long-
term, potentially invalid overestimates may lead to a perception of ineffective policies and
treatments, which may then lead to diminished resource allocation. Thus, the possibility that
child abuse estimates are inflated due to methodological bias has great practical significance
for both practice and policy in this field.
This research literature balks at coherent summarization because of such disparate findings.
Its divergent estimates of child abuse prevalence trends may be resultant from changes in a
number of potentially salient factors: the true incidence of abuse, familial characteristics
(Wodarski & Johnson, 1988), environmental characteristics such as socioeconomic status
(Zuravin, 1989)) and/or methodological ones. We are unaware of any study which has empiri-
cally examined the relationship of the later to child abuse prevalence estimates. For example:
What is the relationship between study response rates and prevalence estimates? Previous
reviews (Howing et al., 1989; Peters, Wyatt, & Finkelhor, 1986; Wyatt & Peters, 1986a;
1986b) and an independent study (Haugaard & Emery, 1989) have hypothesized or merely
described the potentially confounding influence of selective participation or response bias, as
well as other methodological variables (e.g., the diverse array of child abuse definitions repre-
sented in the extant literature) on prevalence estimation, but have not directly assessed the
extent of such bias. The present study, an integrative review, will address these methodological
concerns.
Health and social-behavioral survey response rates have declined significantly over the past
three decades (Pottick & Lerman, 1991). For example, a meta-analysis of 21 hypertension
surveys found that prior to 1975, one-quarter of the studies reported response rates less than
70%, however, more than two-thirds of the more recent surveys had response rates below this
criterion (Gorey & Trevisan, unpublished). Moreover, the potentially confounding influence
of this phenomenon is underscored by research findings on responders/participators versus
those who choose not to be included in social, behavioral, or biomedical research. Response
status has consistently been found to be associated with a number of participant characteristics
such as age and socioeconomic status, but most importantly, response is typically highly
associated with the problem under investigation (Bigger & Melbye, 1992; Criqui, Barrett-
Connor, & Austin, 1978; Fortbofer, 1983; Gorey, Rice, & Brice, 1992; Vernon, Roberts, &
Lee, 1982). For example, in empirically reviewing 17 studies on the prevalence of employed
people providing direct care for older people, Gorey and colleagues ( 1992) found the estimate
of “elder caregiving” among studies with high response rates (60% or higher) to be approxi-
mately lo%, while the less rigorous studies’ average estimate was more than two-fold greater
(25%), perhaps a gross overestimation of the truth.
Such demonstrable bias may also intrude into the research literature on child abuse preva-
lence. Indeed, given its great methodological variability (e.g., response rates vary from 48%-
99%; Finkelhor, 1994), it is likely that the research in this field is uninterpretable without
accounting for such potential bias. The present integrative review empirically examines this
concern; it predicts that substantial variability among child abuse prevalence estimates will
be explained by the study methodological characteristics of response rate and child abuse
definitions.
 Prevalence of child sexual abuse 393

METHOD

Computerized data bases of Psychological, Sociological, and Social Work Abstracts, and
Index Medicus were searched ( 1965 to the present) on the following key word scheme: child
abuse, neglect or maltreatment (sexual, physical, or psychological/emotional) and prevalence,
incidence, survey, or epidemiology. The “published” peer-reviewed press was employed as
a sampling frame to provide some measure of quality assurance; conference proceedings,
unedited monographs, dissertations and government documents were excluded. However, as
this review’s hypothesis (i.e., response rate-estimated prevalence of child sexual abuse associa-
tion) was not the central concern of any of the original studies, publication bias is not likely
to be a potent alternative explanation for its integrative or meta-findings. These searches
were then augmented with bibliographic reviews of relevant manuscripts which estimated the
prevalence of child abuse among nonclinical, North American samples. Studies of clinical or
registry-based samples were excluded because historical (e.g., political [legislative] and cul-
tural) confounders associated with increasingly more effective case identification strategies
would most assuredly fatally flaw any panel comparisons of their child abuse prevalence
estimates. A total of 16 studies were retrieved; they comprise this integrative review’s sample
(see References-Special Section). Aggregating samples across categorically similar studies,
prevalence estimates were compared across response rates and child abuse definitions.

RESULTS

Sample Description
This review’s sample of 16 studies on the prevalent past experience of child (less than 18
years of age) abuse among adults (18 years of age or older) arose primarily from United
States populations (n = 14, 87%; the remaining two were Canadian studies) during the past
25 years (data were collected from 1969 to 1991, M&r = 1983). Slightly more than two-
thirds (68%) of their aggregate respondent sample was female. This is not a surprising gender
distribution given that six of the primary studies sampled women only, while only one of them
exclusively sampled men. Twelve (75%) of the reviewed studies randomly sampled from
general population sampling frames; the remaining four convenience sampled from such “cap-
tive audiences” as college students. These diverse samples (ranged from 248 to 3,520 respon-
dents, Mdn = 1,040) were then interviewed using a variety of methods: six each face-to-face
and mail surveys, and four telephone surveys.

Response rates and dejnitions of abuse. Response rates among the 16 reviewed studies (25
research questions/hypotheses) varied widely from 25% to 98%. On average, less than two-
thirds of the people contacted agreed to participate (Mdn = 64.0%, M = 62.2%, SD = 17.6).
The criterion of 60% has been suggested as characterizing a “good” survey (Babbie, 1989);
13 of the samples met this criterion and 12 did not. Moreover, response rates in this field of
inquiry have diminished significantly over time: data collected from 1969 to 1984 (M =
68.2%, SD = 14.6) versus 1985 or later (M = 49.4%, SD = 17.6); F( 1, 23) = 6.98, p <
.05. Given the known associations of response status with numerous study variables of interest
(health status and problems-in-living) and more specifically, its likely association with this
review’s central variable of interest, that is, child abuse, response bias may itself account for
any observed change in the prevalence of child abuse over time. This potential alternative or
confound hypothesis is examined empirically in the proceeding section.
The nature of the question being posed is the centerpiece of a study’s design. Obviously,
how a question is asked may greatly influence responses to it. The studies of child abuse
394 K. M. Gorey and D. R. Leslie

prevalence among nonclinical populations which have been published thus far almost exclu-
sively assess sexual abuse (15 of the 16 included in this review); only one assessed physical
abuse. We are not aware of a single extant study on similar prevalent child psychological or
emotional abuse, nor of child neglect. Even the operational definitions of child sexual abuse
varied widely, from very narrow definitions (e.g., forced intercourse, less than 1 week) to
much broader ones (e.g., ever [as a child] experienced any of eight sexual behaviors with an
adult-exhibitionism through fondling to intercourse). Consequently, this factor will also be
accounted for in the proceeding analysis.

Prevalence of Child Abuse

Aggregating all 25 of the samples, the estimated prevalence of child sexual abuse was found
to be 22.3% among women and 8.5% among men, a finding which is certainly consistent with
known gender differences on abuse. Also consistent with popularly held notions, as well as
with the majority of previously reported research in this field; the unadjusted comparisons
of recent versus earlier research indicated that the prevalence of such abuse among both
women and men has increased significantly (see top of Table 1). However, this trend is
confounded by the above noted concomitant decrease in study response rates during the
same period of time.

Response and measurement biases. As expected, the estimated prevalence of child abuse was
inversely associated with study response rate. For example, among aggregated female samples,
the child abuse prevalence estimate among poor response surveys (27.8%) was two-thirds

Table 1. The Prevalence of Child Sexual Abuse by Study Methodological Characteristics

Number of Aggregate Prevalence of Prevalence Ratio
Characteristic Group Studies Sample” Abuse (%) (95% CIb)

Year Data Collected

Female
1969- 1983 8 6,158 20.1’
1984 or later 8 1,720 23.3 1.16 (1.09, 1.24)
Male
1969-1983 5 5,357 5.7
1984 or later 4 2,099 11.9 2.09 (1.79, 2.44)
Response Rate
Female
60% or more 8 7,116 16.8
Less than 60% 8 6,762 27.8 1.65 (1.55, 1.76)
Male
60% or more 4 3,429 7.9
Less than 60% 5 4,027 8.9 1.13d (0.97, 1.32)
Child Abuse Definition’
Female
Narrow 4 2,385 8.3
Middle 6 4,444 17.8 2.14 (1.87, 2.45)
Broad 6 7.049 36.2 4.36 (3.88, 4.91)
Male
Narrow 2 472 6.6
Middle 4 2,503 7.2 1.09 (0.77, 1.54)
Broad 3 4,481 11.5 1.74 (1.25. 2.43)

a Combined samples across studies in category.

b Confidence intervals are chi-square test-based (Miettinen, 1976).
’Baseline for prevalence ratio (PR) calculation.
d Significant at p < .lO; 90% CI = 1.00, 1.31.
eExamples of operational definitions: narrow- ‘severe’ sexual abuse, involved force, for less than one week; broad-
ever experienced any of four to eight sexual behaviors with an adult, from exhibitionism through fondling to intercourse.
 Prevalence of child sexual abuse 395

greater than that estimated among so-called “good” surveys, ones with response rates of 60%
or greater ( 16.8%) ; prevalence ratio (PR) = 1.65, 95% confidence interval (CI = 1.55, 1.76).
A similar inverse association which approached statistical significance (90% CI, or p < . IO)
was observed among the aggregated male samples. Also, as one would intuitively expect, the
use of broader operational definitions of child sexual abuse (e.g., those including forms of
noncontact abuse such as exhibitionism) resulted in significantly greater prevalence estimates
than narrower ones (see bottom of Table 1) . Female and male child sexual abuse prevalence
estimates adjusted for operational definitions (excluding the broadest, noncontact category)
respectively were 14.5% and 7.2%. Next, a multiple linear regression with each study’s total
sample estimated child abuse as the criterion ( [aggregate prevalencefemale + prevalence,d,] /
2, mean substitution for missing data) was run. Together, these two study methodological
characteristics accounted for half of the variability among abuse prevalence estimates (R’ =
.500; response rates, 11% [p = .228, p < .05] and operational definitions, 39% [p = .631,
p < .OS]), F(2, 13) = 9.51, p < .05. In fact, after these two factors entered the linear
regression model, none of the other study characteristics (year of data collection, Canada vs.
U.S., sample size, probability or convenience sample, general population or college sample,
interview method) entered.

DISCUSSION

Interpretation of the extant body of research on the prevalence of child abuse ought to be
accompanied by extreme cognizance of study characteristics. The two study methodological
characteristics of response rates and abuse operational definitions account for half of the
variability among reported outcomes on estimated child sexual abuse prevalence. In fact, the
trend of increasing child abuse previously observed by some may be a mere methodological
artifact, a function of decreasing survey participation over time.
This study’s finding of an inverse response rate-child abuse prevalence association (the
greater a study’s response rate, the lower its prevalence estimate) is consistent with that of a
previous survey which observed this phenomenon across three separate samples (response
rates of 25%, 42%, and 74%; Haugaard & Emery, 1989); it replicates their finding across all
16 of the surveys in the field. Both support the notion that adults who have experienced child
abuse are more likely to respond to such surveys than their nonabused counterparts are. The
telling of their stories in an anonymous forum may provide them with a catharsis, an opportunity
to break through their isolation while maintaining a safe interpersonal distance. This simple
methodological characteristic has a great impact on the inferences one may make from this
aggregate research literature. A simple unadjusted summarization of all of the studies infers
that approximately 22% and 9% of women and men, respectively, were sexually abused as
children, whereas, restricting the analysis to only those samples with 60% or greater response
rates, results in the lower, and perhaps more valid, prevalence estimates of 17% and 8%. It
should be noted here that the average response even among these “good” surveys was only
69%. Conservatively adjusting for this potential bias (assuming that none of the nonrespondents
were abused), abuse estimates of 12% and 5% may be inferred. The truth probably lies
somewhere between these two adjusted estimates: females (12%- 17%) and males (5%-80/o).
A final caveat ought to be recalled; this extant literature on child abuse prevalence nearly
exclusively assesses sexual abuse. Prevalence estimates of emotional abuse, for example, or
neglect, which have not yet been directly assessed, may be expected to be two-fold greater or
more (Chambers, 1995 ) .
All of the above summarized review-generated findings ought to be confirmed (or refuted)
with primary research (Cooper, 1989). Not a single large, population-based study with proba-
bility sampling and a very high rate of participation has yet been reported in this field’s peer-
396 K. M. Gorey and D. R. Leslie

reviewed press (extant studies with response rates greater than 90% were convenience sam-
pled). Such a study is sorely needed. While it is true that such a study, employing multiple
procedures to ensure very high participation (e.g., generous monetary remuneration for partici-
pation, multiple nonrespondent follow-up, and so on) would be relatively expensive, its resul-
tant information value may be expected to exceed that of all 16 previous studies in this field
combined. Practice methods are presently being developed and show promise for effective
treatment and ultimate prevention of child abuse (Benick & Barth, 1992; de Jong & Gorey,
1996; Richter, Snider, & Gorey, 1997), however, valid baselines will eventually be needed to
more rigorously assess related policies and programs. An epidemiologic strategy for knowledge
building about a disease/problem typically follows the following linear strategy: ( 1) frequency;
(2) distribution; (3) correlates/determinants; and (4) treatment. Concerning the research
agenda on child abuse, from a practical standpoint, to take pause, go back, and validly answer
level-one questions concerning abuse frequency (prevalence) would go a long way toward
facilitating effective practice as well as other research in this field.

REFERENCES

Babbie, E. (1989). The practice of social research (5th ed.). Belmont, CA: Wadsworth.
Bagley, C. ( 1990). Is the prevalence of child sexual abuse decreasing? Evidence from a random sample of 750 young
adult women. Psychological Reports, 66, 1037-1038.
Beitchman, J. H., Zucker, K. J., Hood, J. E., DaCosta, G. A., & Akman, D. ( 1991). A review of the short-term effects
of child sexual abuse. Child Abuse & Neglect, 15, 537-556.
Beitchman, J. H., Zucker, K. J., Hood, J. E., DaCosta, G. A., Akman, D., & Cassavia, E. (1992). A review of the
long-term effects of child sexual abuse. Child Abuse & Neglect, 16, lOl- 118.
Berrick, J. D., & Barth, R. P. (1992). Child sexual abuse prevention: Research review and recommendations. Social
Work Research and Abstracts, 28, 6- 15.
Bigger, R. J., & Melbye, M. ( 1992). Responses to anonymous questionnaires concerning sexual behavior: A model
to examine potential biases. American Journal of Public Health, 82, 1506- 1512.
Chambers, Z. B. (1995). Correlates of psychological abuse in a nonclinical population. Dissertation Abstracts Intema-
tional, 55( lOA), 3136.
Cooper, H. M. ( 1989). Integrating research: A guide for literature reviews (2nd ed.). Newbury Park, CA: Sage.
Criqui, M. H., Barrett-Connor, E., & Austin, M. ( 1978). Differences between respondents and nonrespondents in a
population-based cardiovascular disease study. American Journal of Epidemiology, 108, 367-372.
Crouch, J. L., & Milner, J. S. (1993). Effects of child neglect on children. Criminal Justice and Behavior, 20, 49-
65.
de Jong, T. L., & Gorey, K. M. ( 1996). Short-term versus long-term group work with female survivors of childhood
sexual abuse: A brief meta-analytic review. Social Work with Groups, 19, 19-27.
Feldman, W., Feldman, E., McGrath, P. J., Pless, R. P., Corsin, L., & Bennett, S. ( 1991). Is childhood sexual abuse
really increasing in prevalence? An analysis of the evidence. Pediatrics, 88, 29-33.
Finkelhor, D. (1994). The international epidemiology of child sexual abuse. Child Abuse & Neglect, 18, 409-417.
Forthofer, R. N. ( 1983). Investigation of nonresponse bias in NHANES II. American Journal ofEpidemiology, 117,
507-515.
Gorey, K. M., Rice, R. W., & Brice, G. C. ( 1992). The prevalence of elder care responsibilities among the work
force population: Response bias among a group of cross-sectional surveys. Research on Aging, 14, 399-418.
Howing, P. T., Wodarski, J. S., Kurtz, P. D., & Gaudin, J. M., Jr. ( 1989). Methodological issues in child maltreatment
research. Social Work Research and Abstracts, 25, 3-7.
Leventhal, J. M. ( 1988). Have there been changes in the epidemiology of sexual abuse of children during the 20th
century. Pediatrics, 82, 766-773.
Lindsey, D. ( 1994). Mandated reporting and child abuse fatalities: Requirements for a system to protect children.
Social Work Research, 18, 41-54.
Malinosky-Rummell, R., & Hansen, D. J. ( 1993). Long-term consequences of childhood physical abuse. Psychological
Bulletin, 114, 68-79.
Miettinen, 0. S. ( 1976). Estimability and estimation in case-referent studies. American Journal of Epidemiology,
103, 226-235.
Peters, S. D., Wyatt, G. E., & Finkelhor, D. (1986). Prevalence. In D. Finkelhor (Ed.), A sourcebook on child sexual
abuse (pp. 15-59). Beverly Hills, CA: Sage.
Pottick, K. J., & Lerman, P. ( 199 1). Maximizing survey response rates for hard-to-reach inner-city populations. Social
Science Quarterly, 72, 172- 180.
Richter, N. L., Snider, E., & Gorey, K. M. (1997). Group work intervention with female survivors of childhood
sexual abuse. Research on Social Work Practice 7. 53-69.
 Prevalence of child sexual abuse 397

U. S. Department of Health and Human Services ( 1988). SrudyJindingst Study of national incidence and prevalence
of child abuse and neglect. Washington, DC: Author.
Vernon, S. W., Roberts, R. E., & Lee, E. S. (1982). Response tendencies, ethnicity, and depression scores. American
Journal of Epidemiology, 116, 482-495.
Wodarski, J. S., & Johnson, S. R. (1988). Child sexual abuse: Contributing factors, effects and relevant practice
issues. Family Therapy, 15, 157-173.
Wyatt, G. E., & Peters, S. D. (1986a). Issues in the definition of child sexual abuse in prevalence research. Child
Abuse & Neglect, 10, 231-240.
Wyatt, G. E., & Peters, S. D. ( 1986b). Methodological considerations in research on the prevalence of child sexual
abuse. Child Abuse & Neglect, 10, 241-251.
Zuravin, S. J. (1989). The ecology of child abuse and neglect: Review of the literature and presentation of data.
Violence and Victims, 4, 101-120.

REFERENCES-SPECIAL SECTION

Bagley, C. ( 1991). The prevalence and mental health sequels of child sexual abuse in a community sample of women
aged 18 to 27. Canadian Journal of Community Mental Health, 10, 103- 116.
Bagley, C., & Ramsay, R. ( 1986). Sexual abuse in childhood: Psychosocial outcomes and implications for social
work practice. Journal of Social Work and Human Sexuality, 4, 33-47.
Elliott, D. M. (1994). The impact of Christian faith on the prevalence and sequelae of sexual abuse. Journal of
Interpersonal Violence, 9, 95- 108.
Finkelhor, D. ( 1979) A survey on children’s victimization. In Sexually victimized children (pp. 34-72). New York:
The Free Press.
Finkelhor, D. ( 1984). Child sexual abuse in a sample of Boston families. In Child sexual abuse: New theory and
research (pp. 69-86). New York: The Free Press.
Finkelhor, D., Hotaling, G., Lewis, I. A., & Smith, C. ( 1990). Sexual abuse in a national survey of adult men and
women: Prevalence, characteristics, and risk factors. Child Abuse & Neglect, 14, 19-28.
Haugaard, J. J., & Emery, R. E. (1989). Methodological issues in child sexual abuse research. Child Abuse & Neglect,
13,89-100.
Kercher, G. A., & McShane, M. (1984). The prevalence of child sexual abuse victimization in an adult sample of
Texas residents. Child Abuse & Neglect, 8, 495-501.
Nuttall, R., & Jackson, H. ( 1994). Personal history of childhood abuse among clinicians. Child Abuse & Neglect,
18, 455-472.
Priest, R. ( 1992). Child sexual abuse histories among African-American college students: A preliminary study.
American Journal of Orthopsychiatry, 62, 475-476.
Risin, L. I., & Koss, M. P. (1987). The sexual abuse of boys: Prevalence and descriptive characteristics of childhood
victimizations. Journal of Interpersonal Violence, 2, 309-323.
Russell, D. E. H. (1983). The incidence and prevalence of intrafamilial and extrafamilial sexual abuse of female
children. Child Abuse & Neglect, 7, 133-146.
Russell, D. E. H. ( 1984). The prevalence and seriousness of incestuous abuse: Stepfathers versus biological fathers.
Child Abuse & Neglect, 8, 15-22.
Siegel, J. M., Sorenson, S. B., Golding, J. M., Bumam, M. A., & Stein, J. A. ( 1987). The prevalence of childhood
sexual assault: The Los Angeles epidemiologic catchment area project. American Journal of Epidemiology, 126,
1141-1153.
Straus, M. A., & Gelles, R. J. (1986). Societal change and change in family violence from 1975 to 1985 as revealed
by two national surveys. Journal of Marriage and the Family, 48, 465-479.
Wyatt, G. E. ( 1985). The sexual abuse of Afro-American and White-American women in childhood. Child Abuse &
Neglect, 9, 507-519.

R&umuette revue inttgrke fait la synthtse de 16 etudes transversales (25 hypothkses) sur la prtvalence de la
maltraitance dans des Cchantillons Nord-Am&&ins non-cliniques. I1 s’agit surtout d’une recherche de la 1ittCrature
sur l’abus sexuel; seule une Ctude a BvaluC les mauvais traitements physiques, et il n’y a pas encore eu une seule
ttude concemant la prkvalence de la maltraitance psychologique ni de la ntgligence. Les infkrences additives suivantes
ont BtC effect&es: ( 1) les taux de rkponses diminuaient au tours du temps de faGon significative, M = 68% avant
1985 et M = 49% pour des Ctudes plus recentes, p < .05, (2) des estimations non-corrigkes de 1’expCrience prevalente
d’abus sexuel &it de 22.3% parmi les femmes et de 8.5% pami les hommes; (3) les taux de rkponse de Ctudes et
les definitions op&ationnelles de maltraitance dtaient responsables pour la moitiC de la variabilitt observte dans leurs
estimations de la privalence de la maltraitance, R 2 = 500, p < .05; (4) les estimations de la p&valence d’abus
sexuels chez les filles et les garqons, corrigCes pour les taux de rtponse (60% ou plus) Ctaient respectivement de
16.8% et de 7.9% et corrigees pour les d&&ions op&ationnelles (excluant la catkgorie la plus large, c’est g dire
celle sans contact) elles ttaient respectivement de 14,5% et de 7.2%); (5) apri?s correction pour les taux de rkponse
et les d&initions, la prkvalence de l’abus sexuel au tours de l’enfance ne variait pas de faGon significative au tours
des 3 dCcades observ&s. Etant don& l’importance des cot&s humains, 2 la fois personnels et sociaux que la maltraitance
398 K. M. Gorey and D. R. Leslie

des enfants induit et les lacunes identifiees dans la connaissance tltmentaire necessaire a initier des programmes
preventifs et therapeutiques efficaces, il est temps d’investir dans une large etude de la maltraitance d’enfants dans la
population g&&ale, en se basant sur une methodologie rigoureuse, qui au moins assurera une tres grande participation.

Resumen-En esta revisi6n se sintetizan 10s resultados de 16 investigaciones (25 hipotesis) sobre la prevalencia de
maltrato infantil en muestras norteamericanas no clinicas. Se trata, fundamentalmente, de una revisidn de la literatura
sobre el abuso sexual, ya que solo un estudio evalda el maltrato ffsico y no hay ninguno sobre la prevalencia de1
maltrato emotional o de1 abandono. Se realizaron las siguientes inferencias: ( 1) las tasas de respuesta disminuyen de
manera significativa a lo largo de1 tiempo, M = 68% antes de 1985 y M = 49% para 10s estudios m&s recientes, p
< .05; (2) las estimaciones globales sobre la prevalencia de experiencias de abuso sexual infantil entre mujeres y
hombres era de1 22.3% y de1 8.5%, respectivamente; (3) las tasas de respuesta a cada estudio y las definiciones
utilizadas sobre el maltrato infantil, en conjunto, explicaron la mitad de la variabilidad observada en sus estimaciones
de la prevalencia de1 abuso, R2 = ,500, p < .05; (4) una vez controlado el efecto de las tasas de respuesta (60% o
m&s), la prevalencia estimada de abuso sexual infantil para mujeres y varones era de1 16.8% y 7.9%, respectivamente;
realizado el control sobre las definiciones de abuso (se excluyeron las mas amplias y las que incluian categorias sin
contact0 fkico) las estimaciones de prevalencia eran de 14.5% para las mujeres y de 7.2% para 10s varones; (5)
despues de controlar tanto las tasas de respuesta y las definiciones, la prevalencia de1 abuso sexual infantil observada
no varia significativamente a lo largo de las tres decadas revisadas. Dado et gran costo humano, tanto personal coma
social, de1 maltrato infantil, y la laguna identificada en 10s conocimientos necesarios para llevar a cabo intervenciones
preventivas y terapeuticas efectivas, se considera que es el moment0 para invertir esfuerzo en estudios de1 maltrato
infantil, amplios metodoldgicamente rigurosos y basados en poblacion general, que, si no hacen nada mas, no ahorren
recursos en asegurar tasas muy altas de participation.